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El. knyga: Building Safer Healthcare Systems: A Proactive, Risk Based Approach to Improving Patient Safety

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  • Formatas: PDF+DRM
  • Išleidimo metai: 21-Aug-2019
  • Leidėjas: Springer Nature Switzerland AG
  • Kalba: eng
  • ISBN-13: 9783030182441
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Building Safer Healthcare Systems: A Proactive, Risk Based Approach to Improving Patient SafetyDidesnis paveikslėlis
  • Formatas: PDF+DRM
  • Išleidimo metai: 21-Aug-2019
  • Leidėjas: Springer Nature Switzerland AG
  • Kalba: eng
  • ISBN-13: 9783030182441
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This book offers a new, practical approach to healthcare reform. Departing from the priorities applied in traditional approaches, it instead assesses both theoretically and practically the successful lessons learned in other safety-critical industries, and applies them to healthcare settings. The authors focus on the importance of human factors and performance measures to establish proactive, systematic methods for healthcare system design. This approach helps to identify potential hazards before accidents occur, enhancing patient safety.





In addition, the book details the new approach on the basis of real-world applications in the NHS and insights from NHS staff. Case studies and results are presented, demonstrating the significant improvements that can be achieved in risk reduction and safety culture.





Lastly, the book outlines what steps healthcare organisations need to take in order to successfully adopt this new approach. The approach and experiential learning isbrought together through the development of a new holistic patient safety education syllabus.
Part I The Conceptual Underpinning to a Paradigm Shift to Improving Patient Safety and the Emergence of the Safer Clinical System Approach
1 Patient Safety: Why We Must Adopt a Different Approach
3(8)
1.1 Introduction
3(1)
1.2 Patient Safety-Where We Are Now
4(1)
1.3 Advocated Approaches to a Different Model of Patient Safety
5(3)
References
8(3)
2 Learning from Safety Management Practices in Safety-Critical Industries
11(20)
2.1 Introduction
11(1)
2.2 Proactive Risk Management
12(1)
2.3 The Risk Concept
12(2)
2.4 Risk Assessment
14(1)
2.5 Risk Management
15(3)
2.6 Patient Safety Risk Management
18(1)
2.7 Safety Cases-Demonstrating and Critiquing the Safety Position
18(2)
The Concept of a Safety Case
18(2)
2.8 Using Safety Cases in Healthcare
20(1)
2.9 Organisational Learning
20(1)
2.10 The Challenges of Organisational Learning in Healthcare
21(1)
2.11 Learning from the Ordinary
22(1)
2.12 Is Healthcare a Safety-Critical Industry
23(1)
2.13 Patient Perception of Risk
24(1)
2.14 Reliability of Clinical Processes
24(1)
2.15 The Focus of Regulation
25(1)
2.16 Summary
26(1)
References
26(5)
3 Human Factors and Systems Approach to Patient Safety
31(14)
3.1 Introduction
31(1)
3.2 Human Factors in Healthcare
31(2)
3.3 Two Contrasting Views on Error in Clinical Systems
33(1)
3.4 The Person-Centred Approach
33(2)
3.5 The Systems Perspective
35(1)
3.6 A Human Factors Approach to Managing Error
36(1)
3.7 Hierarchical Task Analysis
36(2)
3.8 Systematic Human Error Reduction and Prediction Approach
38(2)
3.9 Summary
40(1)
References
41(4)
4 Safety and Culture: Theory and Concept
45(6)
4.1 Introduction
45(1)
4.2 What Is Understood by the Term Safety Culture?
46(1)
4.3 Safety Culture and Links to Organisational Performance
47(2)
References
49(2)
5 An Outline of the Evolution and Conduct of the Safer Clinical Systems Programme
51(20)
5.1 The Development of the Approach
51(1)
Background of the Ideas
51(1)
5.2 Summary of Phase 1 September 2008 to December 2010
52(3)
5.3 Phase 2-January 2011 to December 2013
55(1)
5.4 Roles
55(1)
5.5 Timescales
56(1)
5.6 How to Build Safer Clinical Systems-A Description of the Approach
56(3)
5.7 Safer Clinical Systems-The Five Steps
59(1)
5.8 Step 1-Your Pathway and Its Context
60(2)
Why This Is Important?
60(1)
What Do We Mean by 'A Pathway'?
60(1)
Tools and Techniques You Can Use
61(1)
Manchester Patient Safety Framework (MaPSaF)
61(1)
The Safety Culture Index (SCI)
61(1)
Your Outputs from Step 1
61(1)
5.9 Step 2-System Diagnosis
62(2)
Why This Is Important?
62(1)
Tools and Techniques You Can Use
62(1)
Failure Mode and Effects Analysis (FMEA)
63(1)
Human Factors Analysis
63(1)
Your Outputs from Step 2
63(1)
5.10 Step 3-Option Appraisal
64(1)
Why This Is Important?
64(1)
Tools and Techniques You Can Use
64(1)
Your Outputs from Step 3
64(1)
5.11 Step 4-Planning
65(2)
Why This Is Important
65(1)
Tools and Techniques You Can Use
66(1)
Designing for Safety
66(1)
Your Outputs from Step 4
66(1)
5.12 Step 5-System Improvement
67(1)
Why This Is Important?
67(1)
Tools and Techniques You Can Use
67(1)
5.13 The Safety Case-(More Details and a Worked Example of Use of a Safety Care Is Given in Part II)
67(1)
5.14 Your Outputs from Step 5
68(1)
References
68(3)
Part II Implementing Safer Clinical System-Examples of SCS in Practice and Outcomes; and Next Steps to Wide Scale Dissemination
6 Building Safer Healthcare Systems
71(40)
6.1 Introduction and Background
71(1)
6.2 The Safer Clinical Systems Approach
71(1)
6.3 The Organisational Context
72(1)
6.4 MaPSaF
72(3)
6.5 Reporting and Learning
75(2)
6.6 Developing Safer Clinical Systems
77(1)
6.7 Diagnosis-Rationale and Overview
78(1)
6.8 Tools and Techniques
79(1)
6.9 Process Mapping
80(1)
6.10 Failure Mode and Effects Analysis (FMEA)
80(1)
6.11 Hierarchical Task Analysis (HTA)
80(1)
6.12 System Diagnosis and Building Safety
81(2)
Risk Evaluations
81(2)
6.13 Option Appraisal and Improvement
83(9)
6.14 Design of Interventions
92(2)
6.15 Uncovering Risk-A Platform for Safety Management
94(2)
6.16 Residual Risks-Escalation and Governance
96(1)
6.17 The Safety Case
97(1)
Overview
97(1)
6.18 Safety Cases in Practice
98(2)
6.19 A Safety Case in Medicines Management
100(6)
Safety Claim
105(1)
Evidence of Risk
105(1)
Residual Risk
105(1)
Interventions and Metrics Required
105(1)
Confidence Statement
106(1)
6.20 Safety Cases and Regulation
106(1)
6.21 Concluding Remarks
107(1)
References
108(3)
7 A Practical Effective Tool for Measuring Patient Safety Culture
111(14)
7.1 Introduction
111(1)
7.2 Measuring Patient Safety Culture
112(1)
7.3 Developing the Safety Culture Index (SCI)
113(1)
7.4 Scope for Service Improvement
114(9)
Degree of Bureaucracy
114(7)
Brief Definition of the Safety Culture Index (SCI) Scales
121(2)
References
123(2)
8 A Systems Approach to Improving Clinical Handover in Emergency Care
125(12)
8.1 Introduction
125(1)
8.2 The Trouble with Handover
126(1)
8.3 The Benefits and Limitations of Standardisation
127(2)
8.4 The Influence of Clinical Systems, Organisational Processes and the Institutional Context
129(1)
8.5 Work-as-Done: The Goals and Functions of Handover
129(1)
8.6 Systematic Identification of Major Vulnerabilities-SHERPA Analysis
130(2)
8.7 System Changes to Improve Handover
132(1)
8.8 Summary
133(1)
References
133(4)
9 Evaluation of the SCS Approach
137(20)
9.1 New Perspectives on Safety
138(1)
9.2 Applying the Learning from the SCS Approach-Some Practical Advice
138(1)
9.3 The Use of the Tools and Techniques
139(1)
9.4 Process Mapping
139(1)
9.5 Failure Mode and Effects Analysis (FMEA)
140(1)
9.6 Hierarchical Task Analysis (HTA)
141(2)
9.7 Option Appraisal
143(1)
9.8 Choice of Intervention Shortlist
143(1)
9.9 Evidence to Support Decision-Making
144(1)
9.10 Final Choice of Interventions
144(1)
9.11 Human and Performance Influencing Factors and Related Issues
145(1)
Managing the Process
145(1)
9.12 Performance Influencing Factors
146(1)
9.13 Induction and Coaching New Team Members
146(1)
9.14 How Junior Doctors Prioritise Activity
147(1)
9.15 Goals for the 'Board-Round'
147(1)
9.16 Prevailing Culture of Handover
147(1)
9.17 Ownership of the Change
147(1)
9.18 Spread and Generalisability
148(1)
9.19 Single-Point Interventions
148(1)
9.20 Hierarchy of Control
148(1)
9.21 Sustainability
148(1)
9.22 What Helps
148(1)
9.23 What Hinders?
149(1)
9.24 Sustaining the Safety Improvement Approach
149(1)
9.25 Conclusion on Learning from the Safer Clinical Systems Programme
149(1)
9.26 Some Key Points from the External Evaluation
150(1)
9.27 The Diagnostics-Some Examples of Underlying Safety Problems
151(1)
9.28 The Interventions
152(2)
9.29 Post-programme Response to the Evaluation and Follow-up Work
154(1)
9.30 In Conclusion
155(1)
References
156(1)
10 Moving Forward: A New Patient Safety Curriculum
157(22)
10.1 Patient Safety Syllabus
160(1)
About this Syllabus-What You Need to Know
160(1)
Why Is It Different?
160(1)
10.2 How Will It Make a Difference to Clinicians?
160(1)
10.3 Is It Just About Non-Technical Skills?
160(1)
10.4 Where Does This Work Come From?
161(1)
10.5 What Impact Will This Work Have?
161(1)
10.6 Patient Safety Syllabus
161(3)
Introduction
161(1)
Key Domains and Underpinning Knowledge
162(1)
Key to Structure
163(1)
Outcomes
164(1)
10.7 Domain 1-Systems Approach to Patient Safety Outcomes
164(2)
10.8 Domain 2-Learning from Incidents
166(3)
Outcomes
166(3)
10.9 Domain 3-Proactive Management of Patient Safety
169(3)
Outcomes
169(3)
10.10 Domain 4-Creating Safe Systems
172(3)
Outcomes
172(3)
10.11 Domain 5-Being Sure About Safety
175(2)
Outcomes
175(2)
References
177(2)
Appendix A: Learning from Incidents 179(4)
Appendix B: Underpinning knowledge and Expertise to Support Syllabus Domains 183
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